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Betty Miller: An Older Female with Right Shoulder Pain

Betty Miller is a 77-year-old female who has had right shoulder pain for 4 weeks. Through the case study, you will follow Betty through a visit to her primary care provider and pharmacist; a home health services for nursing, social services and physical therapy; and a primary care provider follow-up visit.

Delores: Musculoskeletal Pain and Moderate to Severe Dementia

Mrs. Rose is an 89-year-old, widowed white female who has resided in a nursing home for the past 3 months.  Admission was precipitated by inability to function independently, related to Dementia Alzheimer’s –type (DAT) and to widespread arthritic pain.  Her mobility is severely limited.

Donald Williams: Older Adult Right Total Knee Arthroplasty

Donald Williams is a a 77-year-old veteran with osteoarthritis and an old football injury to his right knee. He has just undergone a right knee total arthroplasty 5 days ago.

Edna: An Older Adult with Chronic Low Back Pain

Edna is a 70-year-old woman with chronic low back pain.  After completing the course, you should be able to differentiate the weak link and the treatment targets in older adults with chronic low back pain, articulate realistic treatment expectations for chronic non-cancer pain, and describe a rational stepped care treatment approach for older patients with chronic low back pain.

Luisa Sanchez: Hispanic Older Adult with Acute Neck Pain

Luisa is a 69-year-old Hispanic woman who is having acute neck pain. Her pain began two weeks ago, after she spent two days making tamales for a church function.

Margaret Anderson: An Older Adult with Limited Communication

Margaret Andersen is an 85-year-old woman with limited communication who demonstrates changes in behavior two weeks after entering a nursing care facility.

Mary: Pain in a Patient with Metastatic Cancer

Mary is a 74 year old woman with a history of breast cancer metastatic to the ribs, hypertension, and osteoarthritis. She complains of newly developed right-sided hip pain.

Mildred: An Older Adult with Persistent Knee Pain and Dementia

Mildred is 83 years old and suffers from chronic, constant knee pain that prevents her from doing things around the house. She recently moved next door to her son so he can provide the extra help she needs with grocery shopping, cooking, and doing heavier housework. An x-ray of her knee displays moderate to severe knee osteoarthritis.

Mr. Clark: Gout in an Older Adult

Mr. Clark is an 80 year old, moderately overweight Caucasian male who awoke two nights ago with severe pain in his left foot. He has tried elevating his foot and has taken ibuprofen, with minimal pain relief. His wife states that he has some problems with his memory. She states that he has not been able to sleep, and asks the urgent care staff to give him something for the pain as well as something to help him sleep.

Mr. Frank: Pain Assessment in Cognitively Impaired Older Adults

Mr. Frank is an 80-year-old nursing home resident. Recent years have been marked by progressive cognitive decline attributed to Alzheimer’s disease. Two days prior to admission, the nursing home staff noted decreased oral intake and resistance to care but were able to dose usual medications. This progressed over the subsequent day with Mr. Frank noted to be agitated, resistant to care and uncharacteristically aggressive. Transfer to acute care facility was arranged after Mr. Frank fell from his chair.

Mr. Gateway: Acute and Chronic Head Pain

Mr. Gateway is a 52-year-old male smoker with a history of substance abuse with recurrent laryngeal cancer who presents with increased throat and neck pain, dysphagia (pain with swallowing), and dehydration.

Mr. Monahan: Chronic Knee and Back Pain

Mr. Monahan is a retired, community-dwelling, 81 year old Caucasian male who was a carpet installer for 50 years. He has a history of lower back pain, morbid obesity, hypertension, hypothyroid, occipital lobe stroke, bilateral knee arthroplasty, GERD and sleep apnea. You are seeing Mr. Monahan in his home.

Mrs. Johnson: Geriatric Low Back Pain from the Perspective of the Medical Home Model

Mrs. Johnson is an 80-year-old obese woman with progressively incapacitating low back pain for 1 year.

Mrs. Smith: Postoperative Pain - Inroads Into Pain Management

This module follows an older adult named Mrs. Smith as you explore the physiological and pathophysiological mechanisms for how acute postoperative pain can lead to chronic pain and relevance to post-thoracotomy pain.

Mrs. Wright: Opioid Conversion in Medically Complex Patients

The module follows Mrs. Wright, a 65-year-old woman with a past medical history that includes chronic low back pain, anxiety, hypertension, diabetes and chronic kidney disease.

Mrs. Wright: Opioid Use Risk and Risk Mitigation

The module follows Mrs. Wright, a 65-year-old woman with a past medical history that includes chronic low back pain, anxiety, hypertension, diabetes and chronic kidney disease. Mrs. Wright has been admitted to the hospital for repair of a broken ankle. You, the learner, will assist the orthopedic and pain teams with her care.

Ms. Mondragon’s Acute and Chronic Injuries After a Fall

Ms. Mondragon is a thin, 71-year-old, widowed Hispanic Spanish-Speaking woman whose son is serving as interpreter in the emergency department. Ms. M. fell this morning in her kitchen. She presents with upper back pain, groin pain, and left hip pain radiating anteriorly to the knee.

Pain Assessment in Persons with Dementia

This is an overview of competencies of pain assessment specific to cognitively impaired older adults.

Wendy Jones: Case of Advanced Cancer - Introduction to Primary Palliative Care Skills

Wendy Jones is a 67-year-old woman with terminal cervical cancer who just underwent a colostomy due to bowel obstruction from tumor growth. She continues to complain of significant pain despite large doses of Percocet (7 tabs/day or 100 tablets every two weeks).